Background <p>This study aims to conduct a comprehensive bibliometric analysis to elucidate research trends, collaborative networks, and the thematic evolution of predictors for coronary slow flow (CSF).</p> Methods <p>Relevant literature published between 1977 and 2026 was retrieved from the Web of Science Core Collection database. Bibliometric analysis was conducted utilizing VOSviewer, CiteSpace, and R 4.3.3.</p> Results <p>A total of 366 articles were included, indicating an upward trend in research output. China (118 articles), Turkey (65), and the USA (35) emerged as the leading countries. Prominent institutions included China Medical University (29 articles), Capital Medical University (20), and Tabriz University of Medical Sciences (14). Influential journals were <i>Circulation</i> (impact factor 41.3, JCR Q1), <i>Circulation Journal</i> (5.8, Q1), and <i>American Journal of Physiology-Heart and Circulatory Physiology</i> (3.9, Q1). The most prolific author was Wang Yong, with 12 publications and an H-index of 10. Keyword clustering identified three research themes: pathogenesis of CSF, prediction for CSF following percutaneous coronary intervention, and its prognostic implications. Emerging keywords highlighted increasing attention to “endothelial function”, “prevalence”, “CSF phenomenon”, “myocardial infarction” and “reserve”.</p> Conclusions <p>This study provides a bibliometric overview of key trends and future directions in the field of CSF predictors, emphasizing the growing focus on this area. Future research is anticipated to concentrate on risk stratification and mechanism-targeted intervention strategies.</p> Clinical trial number <p>Not applicable.</p>